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Deresa Dinagde D, Feyisa GT, Afework HT, Chewaka MT, Wada HW. Level of optimal antenatal care utilization and its associated factors among pregnant women in Arba Minch town, southern Ethiopia: new WHO-recommended ANC 8 + model. Front Glob Womens Health 2024; 5:1259637. [PMID: 39081548 PMCID: PMC11286477 DOI: 10.3389/fgwh.2024.1259637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 06/07/2024] [Indexed: 08/02/2024] Open
Abstract
Background To fully realize the life-saving and health-promoting benefits of antenatal care (ANC), the latest World Health Organization (WHO) recommendations call for pregnant women to have at least eight contacts with skilled healthcare providers. This increased number of recommended ANC visits represents a shift toward a more comprehensive, individualized approach to prenatal care. The focus is on health promotion, disease prevention, and the early detection and management of complications during pregnancy. However, in sub-Saharan African countries, including Ethiopia, the coverage rate for this level of recommended antenatal care is only 58%. Given this relatively low utilization, identifying the key risk factors that prevent adequate antenatal care would have significant implications for increasing overall ANC uptake in these regions. Objective The aim of the present study was to assess the level of optimal antenatal care utilization and its associated factors among pregnant women in Arba Minch town, southern Ethiopia in 2023 using the new WHO-recommended ANC 8+ model. Methods An institution-based cross-sectional study was conducted among 416 mothers who were enrolled between 1 December 2022 and 30 January 2023. The total sample size was allocated proportionately to the number of women who delivered at each public health facility. Thus, systematic sampling was applied. Kobo Toolbox was used for data collection and cleaning, which was then analyzed using SPSS Version 26. Statistical significance was determined at a p-value <0.05. Results In this study, the level of optimal antenatal care was 41% [95% confidence interval (CI): 37-45.3]. The associated factors with optimal antenatal care were the presence of pregnancy danger signs [adjusted odds ratios (AOR) = 4.1, 95% CI: 1.87-8.82], having bad obstetric history (AOR = 3.90, 95% CI: 1.94-7.83), antenatal contact at hospital (AOR = 5.11, 95% CI: 2.28-11.21), having good knowledge about antenatal care (AOR = 2.26, 95% CI: 1.15-4.44), women's high decision-making power (AOR = 3.9, 95% CI: 1.2-7.63), and male partner involvement (AOR = 2.0, 95% CI: 1.04-3.78) were positively associated with optimal antenatal care utilization. Conclusion The level of optimal antenatal follow-up is still low. Therefore, it is crucial to provide more information during the antenatal contacts to lower the rate of women discontinued from antenatal care.
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Affiliation(s)
- Dagne Deresa Dinagde
- Department of Midwifery, College of Health Sciences, Mattu University, Mattu, Ethiopia
| | - Gizu Tola Feyisa
- Department of Midwifery, College of Health Sciences, Mattu University, Mattu, Ethiopia
| | - Hana Tadesse Afework
- Department of Midwifery, College of Medicine and Health Sciences, Mizan Tepi University, Mizan Tepi, Ethiopia
| | - Menen Tilahun Chewaka
- Department of Midwifery, College of Medicine and Health Sciences, Mizan Tepi University, Mizan Tepi, Ethiopia
| | - Habtamu Wana Wada
- Department of Midwifery, Health Sciences College, Arba Minch, Ethiopia
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Alinaitwe B, Francis N, Ngabirano TD, Kato C, Nakamya P, Uwimbabazi R, Kaplan A, McCoy M, Ayebare E, Winter J. Delivery of a post-natal neonatal jaundice education intervention improves knowledge among mothers at Jinja Regional Referral Hospital in Uganda. PLoS One 2024; 19:e0301512. [PMID: 38574088 PMCID: PMC10994313 DOI: 10.1371/journal.pone.0301512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 03/17/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Neonatal jaundice (NNJ) is a major contributor to childhood morbidity and mortality. As many infants are discharged by 24 hours of age, mothers are key in detecting severe forms of jaundice. Mothers with limited knowledge of NNJ have a hard time identifying these infants who could go on to have the worst outcomes. This study aimed to determine the effect of a jaundice education package delivered to mothers prior to hospital discharge on maternal knowledge after discharge. METHODS This was a before and after interventional study involving an education package delivered through a video message and informational voucher. At 10-14 days after discharge, participants were followed up via telephone to assess their post-intervention knowledge. A paired t-test was used to determine the effectiveness of the intervention on knowledge improvement. Linear regression was used to determine predictors of baseline knowledge and of change in knowledge score. RESULTS Of the 250 mothers recruited, 188 were fit for analysis. The mean knowledge score was 10.02 before and 14.61 after the intervention, a significant difference (p<0.001). Factors determining higher baseline knowledge included attendance of 4 or more antenatal visits (p < 0.001), having heard about NNJ previously (p < 0.001), having experienced an antepartum illness (p = 0.019) and higher maternal age (p = 0.015). Participants with poor baseline knowledge (β = 7.523) and moderate baseline knowledge (β = 3.114) had much more to gain from the intervention relative to those with high baseline knowledge (p < 0.001). CONCLUSION Maternal knowledge of jaundice can be increased using a simple educational intervention, especially in settings where the burden of detection often falls on the mother. Further study is needed to determine the impact of this intervention on care seeking and infant outcomes.
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Affiliation(s)
- Businge Alinaitwe
- Department of Nursing, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Nkunzimaana Francis
- Clinical Epidemiology Unit, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Tom Denis Ngabirano
- Department of Nursing, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Charles Kato
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Petranilla Nakamya
- School of Public Health, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Rachel Uwimbabazi
- Public Health Commission, Boston, Massachusetts, United States of America
| | - Adam Kaplan
- Center for Care Delivery and Outcomes Research, Minneapolis, Minnesota, United States of America
| | - Molly McCoy
- Global Programs and Strategy Alliance, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Elizabeth Ayebare
- Department of Nursing, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Jameel Winter
- Department of Neonatology, Children’s Minnesota, Minneapolis, Minnesota, United States of America
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Lateef MA, Kuupiel D, Mchunu GG, Pillay JD. Utilization of Antenatal Care and Skilled Birth Delivery Services in Sub-Saharan Africa: A Systematic Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:440. [PMID: 38673351 PMCID: PMC11050659 DOI: 10.3390/ijerph21040440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 03/15/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024]
Abstract
Daily, the number of women who die around the world reaches an average of 800; these deaths are a result of obstetric complications in pregnancy and childbirth, and 99% of these deaths occur in low- and middle-income countries. This review probes the use of antenatal care (ANC) and skilled birth delivery (SBD) services in sub-Saharan Africa (SSA) and highlights research gaps using Arksey and O'Malley's methodological approach. The screening of abstracts and full text was carried out by two independent authors who ensured the eligibility of data extraction from the included articles. An exploration of the data was undertaken with descriptive analyses. In total, 350 potentially eligible articles were screened, and 137 studies were included for data extraction and analysis. From the 137 included studies, the majority were from Ethiopia (n = 40, 29.2%), followed by Nigeria (n = 30, 21.9%). Most of the studies were published between 2019 and 2023 (n = 84, 61%). Significant trends and challenges with ANC and SBD services emerged from the studies. It is revealed that there are wide gaps in the utilization of ANC and SBD services. Policy attention, intervention strategies to improve access, resources, rural-urban disparity, and women's literacy are recommended to improve the utilization of ANC and SBD services in SSA countries.
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Affiliation(s)
- Monsurat A. Lateef
- Faculty of Health Sciences, Durban University of Technology, Durban 4001, South Africa; (D.K.); (G.G.M.); (J.D.P.)
| | - Desmond Kuupiel
- Faculty of Health Sciences, Durban University of Technology, Durban 4001, South Africa; (D.K.); (G.G.M.); (J.D.P.)
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4001, South Africa
| | - Gugu G. Mchunu
- Faculty of Health Sciences, Durban University of Technology, Durban 4001, South Africa; (D.K.); (G.G.M.); (J.D.P.)
| | - Julian D. Pillay
- Faculty of Health Sciences, Durban University of Technology, Durban 4001, South Africa; (D.K.); (G.G.M.); (J.D.P.)
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Kitil GW, Wedajo LF, Feyisa GT, Degefa BD, Marami SN, Walle AD, Chereka AA, Dinagde DD. Exploring the interplay between food security and antenatal care utilization among pregnant women in Southern Ethiopia: Insights from an institution-based cross-sectional study. Eur J Obstet Gynecol Reprod Biol X 2024; 21:100288. [PMID: 38406607 PMCID: PMC10891321 DOI: 10.1016/j.eurox.2024.100288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/01/2024] [Accepted: 02/09/2024] [Indexed: 02/27/2024] Open
Abstract
Background Ensuring the satisfaction of pregnant women with antenatal care is crucial for positive pregnancy outcomes and their engagement with emerging technologies and alternative care models. Maintaining high satisfaction during the antenatal period significantly impacts the well-being of both the expectant mother and the unborn child. Despite the recognized importance of antenatal care satisfaction, comprehensive information on satisfaction levels and influencing factors in the specific study area is lacking. Therefore, this study aims to assess antenatal care service satisfaction and associated factors among pregnant women in Arba Minch town, southern Ethiopia. Methods We conducted an institution-based cross-sectional study among 418 pregnant women from December 2022 to January 30, 2023, using a systematic sampling method. Data were collected using the Kobo Toolbox and analyzed with SPSS Version 26. The threshold for statistical significance was set at a p-value of less than 0.05. Results Out of 418 participants, 54.3% (95% CI=49.4-60.4) expressed satisfaction with antenatal care services. Factors significantly associated with women's satisfaction included: being unable to read and write (AOR=2.37; 95% CI: 1.97-3.80), being aged 25-29 years (AOR=3.20; 95% CI: 1.65-6.22), receiving antenatal care at a hospital (AOR=1.81; 95% CI: 1.05-3.12), having a previous history of antenatal visits (AOR=2.59; 95% CI: 1.26-5.30), a monthly income of 2500-5000 ETB (AOR=1.44; 95% CI: 1.21-3.94), waiting times of less than 30 min (AOR=2.59; 95% CI: 1.52-4.41), maintaining a positive attitude towards antenatal care (AOR=2.50; 95% CI: 1.05-3.65), and having a secure food source (AOR=2.06; 95% CI: 1.13-3.78). Conclusion Over 54% of participants were satisfied with antenatal care services. To improve satisfaction levels, recommended strategies include enhancing healthcare infrastructure, establishing maternity waiting areas, reducing waiting times, and expanding services to remote areas.
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Affiliation(s)
- Gemeda Wakgari Kitil
- Departments of Midwifery, College of Health Sciences, Mattu University, Metu, Ethiopia
| | - Lema Fikadu Wedajo
- Departments of midwifery, College Medicine and Health Sciences, Wallaga University, Nekemte, Ethiopia
| | - Gizu Tola Feyisa
- Departments of Midwifery, College of Health Sciences, Mattu University, Metu, Ethiopia
| | - Bekem Dibaba Degefa
- Departments of Midwifery, College of Health Sciences, Mattu University, Metu, Ethiopia
| | - Shambel Negese Marami
- Departments of Midwifery, College of Health Sciences, Mattu University, Metu, Ethiopia
| | - Agmasie Damtew Walle
- Departments of Health Informatics, College of Health Sciences, Mattu University, Metu, Ethiopia
| | - Alex Ayenew Chereka
- Departments of Health Informatics, College of Health Sciences, Mattu University, Metu, Ethiopia
| | - Dagne Deresa Dinagde
- Departments of Midwifery, College of Health Sciences, Mattu University, Metu, Ethiopia
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Gedef GM, Girma B, Andualem F, Gashaw A, Tibebu NS. Antenatal care utilization and its determinants in fragile and conflict-affected situations in Sekota Zuria District, Northern Ethiopia, 2022: A community-based cross-sectional study. Midwifery 2024; 129:103906. [PMID: 38101294 DOI: 10.1016/j.midw.2023.103906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 11/24/2023] [Accepted: 12/04/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Access to maternal and reproductive health services has been one of the most affected components by armed conflict. Understanding how fragility and conflict may restrict access to maternal health services and promoting situation-specific policy options are crucial for reducing the effects. As a result, this study intends to assess the antenatal care service usage and associated factors in vulnerable and conflict-affected situations in Sekota zuria district, Northern Ethiopia. METHODS A community-based cross-sectional study design was employed on 593 mothers who had given birth in the past two years preceding the survey in the Sekota zuria district from October 15 to 30, 2022. The data were collected by using an interviewer-administered structured and pretested questionnaire. To pinpoint the determining factors, a bivariable and multivariable logistic regression model was applied. For both steps, variables were deemed significant if they had a P-value of lower than 0.05. We use adjusted odds ratios to measure how strongly the dependent and outcome variables are related. RESULTS The prevalence of antenatal care service utilization in the study area was 54.5%, 95% CI: 50.0-58.0%. Considering prenatal visits as routine prenatal checkups (AOR = 2.54, 95% CI: 1.74-3.69), using healthcare providers as a source of information (AOR = 2.30, 95% CI: 1.38-3.81), planned pregnancies (AOR = 1.74, 95% CI: 1.07-2.82), were positively associated with utilization of antenatal care. Whereas, respondents' restricted movement because of insecurity negatively affected the service utilization (AOR = 0.30, 95% CI: 0.18-0.49) CONCLUSIONS: The antenatal care utilization in the study area was 54.5%. Respondents' restricted movement because of insecurity negatively affected the service utilization during the fragile and conflict-affected situation. So it demands designing context and vulnerable group-specific healthcare policies and strategies in fragile and conflict-affected situations. It is also very important to strengthen the availability and accessibility of maternal healthcare services in conflict-affected areas through outreach initiatives and mobile clinics.
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Affiliation(s)
- Getachew Muluye Gedef
- School of Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
| | - Biniyam Girma
- Maternal and Child Health Unit, Amdework Primary Hospital, Waghimra zone, Amhara Regional State, Ethiopia
| | - Fantahun Andualem
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Abeba Gashaw
- Maternal and Child Health Unit, Amdework Primary Hospital, Waghimra zone, Amhara Regional State, Ethiopia
| | - Nebiyu Solomon Tibebu
- School of Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Adrinah MS, Base KL, Tsakani LR. Sources of knowledge empowerment amongst pregnant women with TB disease: A qualitative study in South Africa. Health Expect 2024; 27:e13947. [PMID: 39102690 PMCID: PMC10751458 DOI: 10.1111/hex.13947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 12/08/2023] [Accepted: 12/11/2023] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Providing relevant knowledge to empower all pregnant women diagnosed and nondiagnosed with tuberculosis (TB) is essential worldwide. Proper dissemination of health information for pregnant women could assist in preventing TB complications amongst women and babies. The study aimed to describe the sources of knowledge that empower pregnant women diagnosed with TB and improve their quality of life in Limpopo Province, South Africa. METHODOLOGY The study followed a qualitative, exploratory and descriptive research design. The study was conducted in 12 selected primary healthcare facilities in three crisis districts. Thirty-five pregnant women with TB disease were purposively selected, and face-to-face interviews were conducted to generate data, which were analysed using the thematic approach. Measures to ensure trustworthiness and ethical standards were adhered to. RESULTS The findings of this study revealed that healthcare workers, community stakeholders, and TB ambassadors are the primary sources of knowledge dissemination for capacitating women diagnosed with TB. CONCLUSION Most pregnant women lacked knowledge regarding TB ambassadors as sources of information for empowering women, community awareness campaigns, and Google searches as sources of information sharing. All stakeholders need to work together, considering the patients' charter for TB care that sets out the right for respect and information sharing. The emphasis of this study was on developing a comprehensive educational intervention that could assist in improving the quality of TB services offered to pregnant women.
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Affiliation(s)
- Mulondo Seani Adrinah
- Department of Advanced Nursing ScienceFaculty of Health Sciences, The University of VendaThohoyandouSouth Africa
| | - Khoza Lunic Base
- Department of Health StudiesThe University of South AfricaTzaneenSouth Africa
| | - Lebese Rachel Tsakani
- Department of Advanced Nursing ScienceFaculty of Health Sciences, The University of VendaThohoyandouSouth Africa
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Kitila SB, Feyissa GT, Wordofa MA. Completion of the Maternal Health Care Continuum-Barriers and Facilitators Among Pregnant Women in Jimma Zone, Southwest Ethiopia: A Prospective Study. Health Serv Insights 2023; 16:11786329231214607. [PMID: 38046557 PMCID: PMC10691321 DOI: 10.1177/11786329231214607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 10/23/2023] [Indexed: 12/05/2023] Open
Abstract
Background Continuum of care (CoC) for Maternal Health Care (MHC) is a key strategy aimed at saving lives and promoting the well-being of women and newborns. To achieve the global targets for reducing maternal and newborn mortality, it is preferable to ensure the completion of key care stages (Antenatal, Institutional Delivery, and Postnatal) rather than fragmented care. Therefore, investigating the determinants of CoC completion for MHC is imperative for recommending schemes and designing strategies. Objective To assess the determinants influencing completion of the maternal healthcare continuum among pregnant women in Jimma Zone, Southwest Ethiopia. Methods and Materials A community-based prospective study was conducted from July 2020 to June 2021 among 1065 pregnant women from randomly selected woredas in Jimma Zone. The data were collected, entered using Epi-data and analyzed with SPSS software. Binary logistic regression was used to select candidate variables for multivariate analysis. Multivariate analysis was performed to identify associations between the dependent and independent factors. Principal Component Analysis (PCA) was used to determine the socioeconomic index. Results The overall completion rate was 16.1% (CI, 13.8%-18.5%), with significant dropouts observed between the first and the fourth ANC.Factors associated with the completion of MHC included the women's residence (AOR: 1.73 95% CI: 1.07, 2.81), educational status of their partners (AOR: 5.60 95% CI: 2.40, 13.08), women's occupation (AOR: 2.57 95% CI: 1.28, 5.16), knowledge of ANC (AOR: 7.64 95% CI: 4.03, 14.48), knowledge of PNC (AOR: 4.88 95% CI: 3.21, 7.42), service provided during ANC contacts (AOR: 3.39 95% CI: 1.94, 5.93), parity (AOR: 1.86 95% CI: 1.11, 3.12), time of booking for ANC (AOR: 2.10 95% CI: 1.45, 3.03), and nature of care (AOR: 2.03 95% CI: 1.07, 3.82). Additionally, factors such as topography, distance, lack of transportation, facility closeness, and indirect costs were associated with the completion for MHC. Conclusion and Recommendations The completion rate of CoC for MHC remains low. Factors influencing completion include women's residence, partners' educational status, women's occupation, services provided during ANC, history of PNC use, parity, time of booking for ANC, knowledge of ANC and PNC, and nature of care. To address this, strategies should focus on empowering women economically, improving knowledge of ANC and PNC, enhancing the capacity of health facilities to provide comprehensive ANC services, and making the service delivery more supportive. Further research is recommended to explore the impact of CoC for MHC on birth outcomes.
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Affiliation(s)
- Sena Belina Kitila
- School of Nursing, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | | | - Muluemebet Abera Wordofa
- Population and Family Health Department, Faculty of Public Health, Institute of Health, Jimma University, Ethiopia
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Dadjo J, Omonaiye O, Yaya S. Health insurance coverage and access to child and maternal health services in West Africa: a systematic scoping review. Int Health 2023; 15:644-654. [PMID: 37609993 PMCID: PMC10629958 DOI: 10.1093/inthealth/ihad071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 07/29/2023] [Accepted: 08/02/2023] [Indexed: 08/24/2023] Open
Abstract
BACKGROUND According to the United Nations, the third Sustainable Development Goal, 'Ensure Healthy Lives and Promote Well-Being at All Ages', set numerous targets on child and maternal health. Universal health insurance is broadly seen as a solution to fulfil these targets. West Africa is known to have the most severe maternal mortality and under-five mortality rates in the world. This review seeks to understand whether health insurance provides increased access to services for mothers and children in this region. METHODS The protocol for this review is registered in the International Prospective Register of Systematic Reviews database (CRD42020203859). A search was conducted in the MEDLINE Complete, Embase, CINAHL Complete and Global Health databases. Eligible studies were from West African countries. The population of interest was mothers and children and the outcome of interest was the impact of health insurance on access to services. Data were extracted using a standardized form. The primary outcome was the impact of health insurance on the rate of utilization and access to services. The Joanna Briggs Institute Critical Appraisal Tool was used for methodological assessment. RESULTS Following screening, we retained 49 studies representing 51 study settings. In most study settings, health insurance increased access to child and maternal health services. Other determinants of access were socio-economic factors such as wealth and education. CONCLUSIONS Our findings suggest that health insurance may be a viable long-term strategy to alleviate West Africa's burden of high maternal and child mortality rates. An equity lens must guide future policy developments and significant research is needed to determine how to provide access reliably and sustainably to services for mothers and children in the near and long term.
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Affiliation(s)
- Joshua Dadjo
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Olumuyiwa Omonaiye
- Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Deakin University, Melbourne Burwood, Victoria, Australia
- Deakin University Centre for Quality and Patient Safety Research – Eastern Health Partnership, Box Hill, Victoria, Australia
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Ontario, Canada
- George Institute for Global Health, Imperial College London, London, UK
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Daliri DB, Afaya A, Afaya RA, Abagye N. Postpartum depression: The prevalence and associated factors among women attending postnatal clinics in the Bawku municipality, Upper East Region of Ghana. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e143. [PMID: 38867815 PMCID: PMC11114418 DOI: 10.1002/pcn5.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/25/2023] [Accepted: 08/29/2023] [Indexed: 06/14/2024]
Abstract
Introduction This study examined postpartum depression (PPD) among mothers in the Bawku municipality of Ghana, aiming to assess its prevalence and associated risk factors. Methods A total of 242 women, 2-12 weeks postpartum, were randomly recruited for this cross-sectional analytical study. The Edinburgh Postnatal Depression Scale was used for depression screening, and multivariate logistic regression analysis was employed to assess the factors associated with PPD. Results The study showed that 34.7% of the postpartum mothers were within the age range of 25-29, with a mean age of 27.9 (standard deviation [SD] ± 6.33). The prevalence of PPD was 50.4% (95% confidence interval [CI] 43.9-56.9). Several significant risk factors were identified, including inadequate prenatal visits (adjusted odds ratio [aOR] = 13.44, 95% CI 3.66-49.37, P < 0.001), obstetric complications (aOR = 3.39, 95% CI 1.23-11.19, P = 0.019), less than 3 weeks postpartum (aOR = 8.14, 95% CI 1.95, 33.94, P = 0.004), 6-8 weeks postpartum (aOR = 7.72, 95% CI 1.71-34.80, P = 0.008), and stressful life events (aOR = 3.30, 95% CI 1.23-8.89, P = 0.018). Conclusion The study concluded that the prevalence of PPD in the Bawku municipality is higher than previously reported in Ghana, emphasizing the need for early identification of pregnant women at risk for PPD.
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Affiliation(s)
- Dennis Bomansang Daliri
- Department of Global and International Health, School of Public HealthUniversity for Development StudiesTamaleGhana
- Presbyterian Psychiatric HospitalBolgatangaGhana
| | - Agani Afaya
- Department of Nursing, School of Nursing and MidwiferyUniversity of Health and Allied SciencesHoGhana
- Mo‐Im Kim Nursing Research Institute, College of NursingYonsei UniversitySeoulSouth Korea
| | - Richard Adongo Afaya
- Department of Midwifery and Women's Health, School of Nursing and MidwiferyUniversity for Development StudiesTamaleGhana
| | - Nancy Abagye
- Department of Midwifery, School of Nursing and MidwiferyUniversity of GhanaAccraGhana
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Gezae KE, Berhie KA, Gebresilassie AA, Tsadik M. Contextual Disparity on Trend and Determinants of Optimal Antenatal Care (ANC4+) Use for Women in Eastern Tigray, Ethiopia: Evidence from KA-HDSS Database. Int J Womens Health 2023; 15:511-521. [PMID: 37038463 PMCID: PMC10082613 DOI: 10.2147/ijwh.s399956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Accepted: 03/24/2023] [Indexed: 04/07/2023] Open
Abstract
Background Though optimal antenatal care (ANC4+) use is absolutely critical, only 43% of women had ANC4+ in Ethiopia and nearly 64% in Tigray in 2019. Furthermore, only 20% of women had their first ANC visit during their first trimester in 2016. However, there is no literature on area based disparity of ANC4+ use in Tigray. Therefore, this study is aimed to generate evidence for ANC4+ use using the Kilite-Awlaelo Health and Demographic Surveillance System (KA-HDSS) database. Methods A population-based longitudinal study was employed on 5,414 women from 12 kebelles included in the KA-HDSS site of Tigray. A pregnancy database was used as a source of data. A Line graph was used to depict the trend of ANC4+ use. A stratified robust Poisson model was fitted to estimate the incidence rate ratio (IRR) for women from rural and urban areas separately. Results The ANC4+ coverage was 36.3% (95% CI=35.0-37.6%) - 34.2% in rural versus 52.8% urban areas, with an increasing linear trend. Single marital status (IRR=1.29; 95% CI=1.17-1.42); able to read and write (IRR=1.15; 95% CI=1.01-1.32); primary education (IRR=1.22; 95% CI=1.11-1.34); ANC follow-up (2015-2018) (IRR=1.42; 95% CI=1.23-1.64); previous pregnancy exposure (IRR=2.20; 95% CI=1.98-2.45); and having 6+ children (IRR=1.11; 95% CI=1.01-1.21) determined ANC4+ use for rural women. Marital status (Divorced/widowed/separated) (IRR=0.79; 95% CI=0.66-0.95); primary education (IRR=1.44; 95% CI=1.16-1.79); ANC follow-up (2015-2018) (IRR=2.00; 95% CI=1.59-2.50); previous pregnancy exposure (IRR=1.54; 95% CI=1.31-1.80); and having 6+ children (IRR=1.18; 95% CI=1.07-1.31) determined the ANC4+ use for urban women. Conclusion The optimal ANC coverage is significantly low, with significant disparity by geographical area and increasing trend. However, further efforts have to be made to maximize the optimal use of ANC, particularly for women from rural areas.
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Affiliation(s)
- Kebede Embaye Gezae
- Department of Biostatistics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
- Correspondence: Kebede Embaye Gezae, Email
| | - Kidanemariam Alem Berhie
- Department of Biostatistics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Assefa Ayalew Gebresilassie
- Department of Reproductive Health, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Mache Tsadik
- Department of Reproductive Health, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray, Ethiopia
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Oduro CA, Opoku DA, Osarfo J, Fuseini A, Attua AA, Owusu-Ansah E, Issah S, Barfi A, Kwadzodeh EF, Mohammed A. The burden and predictors of late antenatal booking in a rural setting in Ghana. Nurs Open 2023; 10:2182-2191. [PMID: 36330845 PMCID: PMC10006594 DOI: 10.1002/nop2.1467] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 10/08/2022] [Accepted: 10/22/2022] [Indexed: 11/06/2022] Open
Abstract
AIM The aim of the study was to determine the prevalence and key predictors of late booking among pregnant women accessing antenatal care services in a rural district of Ghana. DESIGN Cross-sectional study. METHODS Data on demographic characteristics, knowledge of accessing antenatal care services and booking gestation were collected from 163 randomly selected pregnant women accessing accessing antenatal care in rural Ghana from 1 March 2022 to 30 April 2022 using a structured questionnaire. The chi-square and logistic regression were used to explore associations between exposure and dependent variables. RESULTS The prevalence of late accessing antenatal care booking among study participants was 44.8% (73/163). About 79.1% (129/163) of them had adequate knowledge of accessing antenatal care services. Maternal age of 35-49 years (AOR: 8.53, 95% CI: 2.41-30.12), participants whose partners had no formal education (AOR: 3.43, 95% CI: 1.03-11.39) and participants with adequate knowledge about accessing antenatal care services (AOR: 0.21, 95% CI: 0.07-0.62) were associated with late booking for accessing antenatal care services among study participants.
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Affiliation(s)
- Charlotte Afful Oduro
- School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Douglas Aninng Opoku
- Department of Occupational & Environmental Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Allen Clinic, Family Healthcare Services, Kumasi, Ghana
| | - Joseph Osarfo
- Department of Community Medicine, School of Medicine, University of Health and Allied Health Science, Ho, Ghana
| | - Adam Fuseini
- Department of Occupational & Environmental Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.,Department of Medicine, Tamale Central Hospital, Ghana
| | - Ama Asamaniwa Attua
- Department of Occupational & Environmental Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Efua Owusu-Ansah
- Department of Global Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Shamwill Issah
- UK Foreign, Commonwealth and Development Office, Accra, Ghana
| | - Augustine Barfi
- Department of Occupational & Environmental Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Ephraim Foanor Kwadzodeh
- Department of Occupational & Environmental Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Aliyu Mohammed
- Department of Epidemiology and Biostatistics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Dickson KS, Boateng ENK, Adde KS, Ameyaw EK, Munro-Kramer ML. Non-adherence to WHO's recommended 8-contact model: geospatial analysis of the 2017 Maternal Health Survey. BMC Pregnancy Childbirth 2023; 23:192. [PMID: 36934240 PMCID: PMC10024456 DOI: 10.1186/s12884-023-05504-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 03/07/2023] [Indexed: 03/20/2023] Open
Abstract
INTRODUCTION Evidence shows that most women in Ghana do not meet the minimum 8-contact model for antenatal care as recommended by WHO with only 31.2%-41.9% of them meeting the recommendation. To the best of our knowledge, no study in Ghana has examined women's noncompliance with the WHO's recommended 8-contact model for antenatal care using geospatial analysis, as this study sets out to do. METHODS We sourced data from the recent version of the Ghana Maternal Health Survey which was executed in 2017. A sample of 10,077 women with complete data participated in this study. The link between the explanatory variables and the outcome variable was investigated using binary and multivariate logistic regression models and Spatial analyses such as spatial autocorrelation (Moran's I), hotspot, cluster and outlier analysis, and geographically weighted regression were conducted using ArcMap version 10.7. RESULTS Districts found in the north-eastern and south-western parts of the country were more likely to experience noncompliance with ANC. Women staying within the middle belt without health insurance were more likely (17-29%) to be noncompliant with ANC. Women with low community socioeconomic status were found to be more likely (17-34%) to be noncompliant with ANC in the eastern parts of Ghana. CONCLUSION The study has shown that in order to achieve targets one and three of Sustainable Development Goal 3, the government of Ghana, the Ministry of Health, together with the Ghana Health Service may have to intensify health education in the identified areas to highlight the importance of adherence to the WHO recommendations on ANC 8-contact model.
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Affiliation(s)
- Kwamena Sekyi Dickson
- grid.413081.f0000 0001 2322 8567Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Ebenezer N. K. Boateng
- grid.413081.f0000 0001 2322 8567Department of Geography and Regional Planning, University of Cape Coast, Cape Coast, Ghana
| | - Kenneth Setorwu Adde
- grid.413081.f0000 0001 2322 8567Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Edward Kwabena Ameyaw
- grid.411382.d0000 0004 1770 0716Institute of Policy Studies and School of Graduate Studies, Lingnan University, Hong Kong, Hong Kong
- L and E Research Consult Ltd, Upper West Region Wa, Ghana
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Kebede AA, Taye BT, Wondie KY. Factors associated with comprehensive knowledge of antenatal care and attitude towards its uptake among women delivered at home in rural Sehala Seyemit district, northern Ethiopia: A community-based cross-sectional study. PLoS One 2022; 17:e0276125. [PMID: 36223422 PMCID: PMC9555639 DOI: 10.1371/journal.pone.0276125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 09/29/2022] [Indexed: 11/07/2022] Open
Abstract
Background Despite the current sustainable development goal period (i.e. SDG 3), the prevention of maternal and neonatal mortality is not satisfactory in Ethiopia. Keeping women knowledgeable about antenatal care and maintaining a positive attitude towards its uptake, particularly in the marginalized rural community is crucial. However, evidence regarding the knowledge and attitude of women towards antenatal care uptake is scarce. Therefore, this study aimed to assess factors affecting comprehensive knowledge of antenatal care and attitude towards its uptake among women delivered at home in rural Sehala Seyemit district, northern Ethiopia. Methods A community-based cross-sectional study was conducted from September 1st to October 15th, 2020. A multi-stage sampling technique was used to select 653 women. The data were collected using a semi-structured interview guide. Data were entered into EPI INFO 7.1.2 and analyzed by SPSS version 25. Both bivariable and multivariable logistic regression analyses were undertaken to identify factors associated with women’s knowledge of antenatal care and attitude towards its uptake. The level of significant association in the multivariable analysis was determined based on a p-value of < 0.05. Results Women’s knowledge of antenatal care and positive attitude towards its uptake was 56.5% and 75.2%, respectively. Older age (AOR = 7.2; 95% CI: 3.43, 15.1), media exposure (AOR = 3.69; 95% CI: 2.41, 5.65), history of abortion (AOR = 11.6; 95% CI: 3.3, 14.6), time to reach health facility (AOR = 4.58; 95% CI: 3.05, 6.88), and history of obstetric danger signs (AOR = 7.3; 95% CI: 3.92, 13.64) were factors significantly associated with knowledge of antenatal care. Furthermore, higher decision-making power (AOR = 8.3; 95% CI: 4.8, 13.83), adequate knowledge of antenatal care (AOR = 2.2; 95% CI: 1.26, 3.71), delivery attended by health extension workers (AOR = 2.3; 95% CI: 1.1, 5.1), and media exposure (AOR = 2.27; 95% CI: 1.30, 3.97) were predictors of a favorable attitude towards antenatal care utilization. Conclusion Although the majority of women in the present study had a favorable attitude towards antenatal care uptake, their knowledge level was inadequate. Strengthening access to transportation, mass media, involvement in household decision-making, and encouraging women to deliver at a health facility by a skilled provider may increase women’s knowledge and attitude towards antenatal care uptake, thereby improving maternal healthcare service uptake.
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Affiliation(s)
- Azmeraw Ambachew Kebede
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Birhan Tsegaw Taye
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Kindu Yinges Wondie
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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ÇELİK ZC, ELBEK ÇUBUKÇU Ç, ÇELİK H, DİNÇ ATA G. Knowledge and Attitudes of Pregnant Women with and without Children about Fluoride and Herbal Toothpastes. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2022. [DOI: 10.33808/clinexphealthsci.1059505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
Objective: Objective: Pregnant women may be vulnerable to dental caries due to their inability to fully implement oral hygiene practices. Toothpastes are main component of oral hygiene and the most important tool for the primary prevention of caries. The study aimed to examine the knowledge and attitudes of pregnant women with children (PC) and without children (PNC) about fluoride and herbal toothpastes.
Methods: A self-administered and validated 20-item questionnaire was completed by a total of 219 pregnant participants, 85 PC and 134 PNC. Statistical analyses were performed using the SciPy v1.2.3. program.
Results: Most of the PC (57.65%; 69.41%) and PNC (72.39%; 47.76%) participants responded with “no idea” when asked about fluoride sources and the optimal amount of fluoride added to tap water by local health authorities (p= .006). The majority of the PC (62.4%) and the PNC (47.0%) had no preference for herbal toothpastes during pregnancy (p= .03). In addition, 86.6% of the PNC showed low knowledge about the nonfluoride content of herbal toothpastes (p= .023). While 51.5% of the PNC responded with “no idea” about a preference for herbal toothpastes for their children, 56.47% of the PC stated that they might not prefer using herbal toothpastes for their children’s routine oral hygiene.
Conclusion: The findings show that both PC and PNC participants had little knowledge of toothpastes and their contents. Considering that toothpastes are the most common self-applied oral hygiene tools, knowledge and awareness of fluoride and herbal toothpastes should be raised via antenatal programs.
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Jesuyajolu DA, Ehizibue P, Ekele IN, Ekennia-Ebeh J, Ibrahim A, Ikegwuonu O. Antenatal-care knowledge among women of reproductive age group in Ido Ekiti, Nigeria. AJOG GLOBAL REPORTS 2022; 2:100073. [PMID: 36276788 PMCID: PMC9563913 DOI: 10.1016/j.xagr.2022.100073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Maternal mortality plagues much of the low- and low-middle-income countries. There were 303,000 maternal deaths in 2015, representing an overall global maternal mortality ratio of 216 maternal deaths per 100,000 live births. 99% of all maternal deaths occur in developing countries. The knowledge of antenatal care is an important factor affecting maternal mortality rates. OBJECTIVE This study aimed to assess the extent of knowledge of antenatal-care services among women of reproductive age in Ido Ekiti, a rural town in South West Nigeria. STUDY DESIGN This cross-sectional study was conducted among 299 women in the reproductive age group, ie, from the ages of 18 to 49 years. Data were collected with a set of self-administered questionnaires and analyzed using SPSS version 25. This study was conducted in Ido Ekiti, a town in the Ido-Osi local government area. RESULTS Most respondents were between 31 and 40 years of age. Most respondents (96%) were educated. 95.6% of the participants in this study were aware of antenatal-care services. 98.7% of the respondents acknowledged that weight and height measurements, abdominal examination, blood tests, and administration of folic acids were carried out during antenatal-care visits. 97.3% had excellent knowledge of the service. CONCLUSION Most respondents were aware of antenatal care and had excellent knowledge of its components. This is indeed a positive finding and is likely because of the high literacy levels, access to electronic media, and the location of 3 public health facilities in the town. Continuous education of women by relevant stakeholders and policymakers on antenatal care should be ensured to maintain the current state and replicate similar findings in other rural areas across Africa.
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Anaba EA, Afaya A. Correlates of late initiation and underutilisation of the recommended eight or more antenatal care visits among women of reproductive age: insights from the 2019 Ghana Malaria Indicator Survey. BMJ Open 2022; 12:e058693. [PMID: 35793917 PMCID: PMC9260762 DOI: 10.1136/bmjopen-2021-058693] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 06/21/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE This study assessed the correlates of late initiation and underutilisation of the WHO's recommended eight or more antenatal care visits among women in Ghana. DESIGN We analysed secondary data from 2163 women in the 2019 Ghana Malaria Indicator Survey, which collected data on malaria and antenatal care indicators among women of reproductive age across the previous 10 regions of Ghana. SETTING AND PARTICIPANTS Women of reproductive age across the 10 regions of Ghana. MAIN OUTCOME MEASURES Late initiation and underutilisation of the recommended eight or more antenatal care visits among women of reproductive age. RESULTS About half (49%) of the participants were between the ages of 25 and 34 years; mean (±SD)=30 (±7.10). The majority (57%) of the participants obtained less than eight antenatal care visits, while 32% initiated antenatal care visits after the first trimester. The significant factors associated with the late initiation of antenatal care visits were age, region and parity (p<0.05). Factors associated with underutilisation of the recommended eight or more antenatal care visits were marital status, wealth index, parity, region and place of residence (p<0.05). CONCLUSION A majority of the women underused antenatal care services. A significant minority of the women started antenatal care visits late. Socio-demographic factors, parity and socioeconomic factors were identified as the significant factors associated with the late initiation and underutilisation of antenatal care services. Maternal health interventions should prioritise young, multiparous and poor women.
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Affiliation(s)
- Emmanuel Anongeba Anaba
- Department of Population, Family and Reproductive Health, University of Ghana School of Public Health, Accra, Ghana
| | - Agani Afaya
- College of Nursing, Yonsei University, Seodaemun-gu, Seoul, South Korea
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
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Taye BT, Kebede AA, Wondie KY. Intention to use maternal health services and associated factors among women who gave birth at home in rural Sehala Seyemit district: a community-based cross-sectional study. BMC Pregnancy Childbirth 2022; 22:213. [PMID: 35296274 PMCID: PMC8928666 DOI: 10.1186/s12884-022-04447-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/02/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Low maternal healthcare service utilization contributes to poor maternal and newborn health outcomes in rural Ethiopia. 'Motivational factors influence women's intention to perform a specific health behavior, and the intention of subsequent home delivery and related risks that may contribute to women's death is less known. Therefore, this study aimed to assess the intention of maternal health service utilization among women who gave birth at home in the rural Sehala Seyemit district. METHODS A community-based cross-sectional study was conducted from September 1st to October 15th, 2020, among 653 women. A two-stage sampling technique was used to select the study participants. First, a semi-structured, pretested, and interviewer-administered questionnaire were used. The mean of the sum score was also used to categorize the intention as intended and not intended. Second, multivariable logistic regression analysis was computed to identify factors associated with women's intention to use maternal health services. Adjusted odds ratio (AOR) with a 95% confidence interval at a p-value of ≤ 0.05 were used to declare statistical association. RESULTS Of the women who gave birth at home the intention to use maternal health service was 62.3% (95% CI; 59, 66). Women's age of > 30 years (AOR = 6.04; 95%CI: 2.34, 15.60), short time to reach health facility (AOR = 2.52; 95% CI: 1.57, 4.10), media exposure (AOR = 2.10; 95% CI: 1.16, 3.65), history of obstetric danger signs (AOR = 4.60; 95% CI: 2.33, 9.10), positive subjective norms (AOR = 11.20; 95% CI; 6.77, 18.50) and last delivery assisted by traditional birth attendants (AOR = 0.15; 95% CI: 0.06, 0.33) were factors associated with women's intention to use maternal health services. CONCLUSION In this study, maternal health service utilization intention is still unsatisfactory compared to the national target plan. Maternal age, media exposure, obstetric danger signs, distance to a health facility, positive subjective norms, and delivery assistant at delivery were predictors of women's intention to use maternal healthcare services. Improving women's awareness of maternal healthcare services and developing strategies to increase women's access to mass media, skilled birth attendants, and transportation for rural women may enhance their intention to use maternal healthcare services.
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Affiliation(s)
- Birhan Tsegaw Taye
- School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, PO. Box 445, Debre Berhan, Ethiopia.
| | - Azmeraw Ambachew Kebede
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kindu Yinges Wondie
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Ambaw YL, Yirdaw BW, Biwota MA, Mekuryaw AM, Taye BT. Antenatal care follow-up decreases the likelihood of cultural malpractice during childbirth and postpartum among women who gave birth in the last one-year in Gozamen district, Ethiopia: a community-based cross-sectional study. Arch Public Health 2022; 80:53. [PMID: 35168678 PMCID: PMC8845281 DOI: 10.1186/s13690-022-00814-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 02/03/2022] [Indexed: 11/15/2022] Open
Abstract
Background Recent evidence has found widespread reports of women experiencing cultural malpractice during childbirth in Asia and sub-Saharan African countries. Despite an endeavor made to drop maternal and neonatal mortality, Ethiopia remains amongst the highest mortality rate. Thus, strengthening antenatal care (ANC) follow-up is the midst of cultural malpractice reduction during childbirth. This study was aimed to assess the magnitude of cultural malpractice and associated factors during childbirth and postpartum among women who gave birth within one year in Gozamen district, Ethiopia. Methods A community-based cross-sectional study was conducted from November 1st to December 30th, 2019. A two-stage sampling technique was used to get a total of 600 women who gave birth within the last one year. Data were collected by using a semi-structured and pretested questionnaire. Then, data were entered into Epi info version 7.0 and exported to SPSS version 25 for analysis. Both bivariate analysis and a multivariable logistic regression model were fitted. The level of significance was declared based on the adjusted odds ratio (AOR) with its 95% confidence interval (CI) and a p-value of ≤0.05. Result The Overall magnitude of cultural malpractices during childbirth and postpartum was found to be 31.2% (95%CI: 27.8, 34.7). Out of 600 women, 203(33.9%) were delivered at home, 67(11.2%) practiced abdominal massage, 31(16.6%) avoided colostrum, 24(12.8%) practiced pre-lacteal feeding and 138 (23%) washed their baby before 24 h after delivery. Mothers who have antenatal follow-up (AOR=0.52 95%CI 0.28, 0.94), married marital relation (AOR=0.24, 95%CI:0.07, 0.89), being farmer husband occupation (AOR=6.25 (95%CI: 1.22, 30.30), parity ≥5 (AOR=5, 95%CI: 2.44, 9.52), had significant association with cultural malpractice during childbirth and postpartum. Conclusions This study showed there is an improvement in the magnitude of cultural malpractices during childbirth and postpartum, but still it’s high as compared to the country’s maternal health service utilization aim. A well-enforced health education program by well-trained healthcare personnel besides sufficient number of ANC visits are needed to overcome these cultural practices. Further, intervention modalities health education communication outreach programs would be very important to reduce the prevalence of cultural malpractices in the community.
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Affiliation(s)
- Yeshinat Lakew Ambaw
- School of Nursing and Midwifery, Asrat Woldeyes Health Sciences Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Birhanu Wubale Yirdaw
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mulunesh Abuhay Biwota
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abebayehu Melesew Mekuryaw
- School of Nursing and Midwifery, Asrat Woldeyes Health Sciences Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Birhan Tsegaw Taye
- School of Nursing and Midwifery, Asrat Woldeyes Health Sciences Campus, Debre Berhan University, Debre Berhan, Ethiopia.
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Vasconcelos A, Sousa S, Bandeira N, Alves M, Papoila AL, Pereira F, Machado MC. Antenatal screenings and maternal diagnosis among pregnant women in Sao Tome & Principe-Missed opportunities to improve neonatal health: A hospital-based study. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0001444. [PMID: 36962895 PMCID: PMC10021443 DOI: 10.1371/journal.pgph.0001444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 11/30/2022] [Indexed: 12/30/2022]
Abstract
Newborn mortality and adverse birth outcomes (ABOs) in Sao Tome & Príncipe (STP) are overwhelmingly high, and access to quality-antenatal care (ANC) is one of the strategies to tackle it. This study aimed to fill the gaps in ANC screenings with a focus on how to improve neonatal outcomes. We conducted a retrospective hospital-based study in which ANC pregnancy cards were reviewed. Screenings were described and compared according to the total number of ANC contacts: 1-3 (inadequate), 4-7 (adequate), and ≥8 (complete). The collected data were entered into QuickTapSurvey and exported to SPSS version 25 for analysis. Statistical significance was considered at a p-value ≤0.05. A total of 511 ANC pregnancy cards were reviewed. Mothers' mean age was 26.6 (SD = 7.1), 51.7% had a first trimester early booking, 14.9% (76) had 1-3 ANC contacts, 46.4% (237) had 4-7 and 38.7% (198) ≥8. Screening absence was found in 24%-41%, lack of money was registered in 36%. Pregnant women had no screening performed for HIV in 4.5%, syphilis in 8.8%, HBV 39.3%, malaria 25.8%, hemoglobin 24.5%, blood glucose 45.4%, urine 29.7%, stool exams 27.8% and 41.1% had no ultrasound. Screening completion for blood group, HIV, malaria, urine, hemoglobin, and coproparasitological exam were found to have a statistically significant difference (p<0.001) for the complete ANC group when compared to other groups. Antenatal problems identified were: 1) bacteriuria (43.2%); 2) maternal anemia (37%); 3) intestinal parasitic infections (59.2%); 4) sickle cell solubility test positive (13%); and 5) a RhD-negative phenotype (5.8%). Missed-ANC treatments were up to 50%. This study reveals a coverage-quality gap in STP since no pregnant woman is left without ANC contact, although most still miss evidence-based screenings with an impact on neonatal outcomes. Strategies such as implementing a total free ANC screening package in STP would enhance maternal diagnosis and prompt treatments.
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Affiliation(s)
- Alexandra Vasconcelos
- Unidade de Clínica Tropical-Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, Lisboa, Portugal
| | | | - Nelson Bandeira
- Hospital Dr. Ayres de Menezes, São Tomé, Sao Tome and Principe
| | - Marta Alves
- CEAUL, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Ana Luísa Papoila
- CEAUL, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Filomena Pereira
- Unidade de Clínica Tropical-Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa, Lisboa, Portugal
| | - Maria Céu Machado
- Faculdade de Medicina de Lisboa, Universidade de Lisboa, Lisboa, Portugal
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20
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Kumbeni MT, Apanga PA, Yeboah EO, Kolog JT, Awuni B. The relationship between time spent during the first ANC contact, home visits and adherence to ANC contacts in Ghana. Glob Health Action 2021; 14:1956754. [PMID: 34402419 PMCID: PMC8381959 DOI: 10.1080/16549716.2021.1956754] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background The World Health Organization in 2016 recommended eight or more antenatal care (ANC) contacts for a positive pregnancy experience, however, it is unclear what impact the time spent during the first ANC contact and home visits can have on eight or more ANC contacts. Objectives Our study investigated the relationship between time spent during the first ANC contact and eight or more ANC contacts, and between home visits and eight or more ANC contacts. We also assessed the prevalence of eight or more ANC contacts. Methods A cross-sectional study was conducted among 519 mothers with children 12 months old and below attending child welfare clinics in the Nabdam district in the Upper East Region, Ghana. Multivariable logistic regression analysis was used to assess the relationship between time spent during the first ANC contact, home visits, and eight or more ANC contacts, while controlling for potential confounders. Results The proportion of mothers who attained eight or more ANC contacts during pregnancy was 31.2%. Spending 20 minutes or more during the first ANC contact was associated with 2.07 times the odds of having eight or more ANC contacts compared to spending less than 20 minutes [adjusted odds ratio (aOR): 2.07, 95% CI: 1.18,3.63]. Mothers who received at least a home visit from skilled health professionals during pregnancy were 2.44 times more likely to have eight or more ANC contacts compared to mothers who were not visited (aOR: 2.44, 95% CI: 1.51,3.94). Conclusion Spending at least 20 minutes during the first ANC contact and home visits were positively associated with eight or more ANC contacts. We recommend that skilled health professionals should spend at least 20 minutes during the first ANC contact as well as encourage home visits in order to increase the coverage of eight or more ANC contacts.
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Affiliation(s)
| | | | - Eugene Osei Yeboah
- Ghana Health Service, Bolgatanga East District Health Directorate, Zuarungu, Ghana
| | | | - Baba Awuni
- Ghana Health Service, Nabdam District Health Directorate, Nangodi, Ghana
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21
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Salia SM, Afaya A, Wuni A, Ayanore MA, Salia E, Kporvi DD, Adatara P, Yakong VN, Eduah-Quansah SA, Quarshie SS, Dey EK, Akolga DA, Alhassan RK. Knowledge, attitudes and practices regarding neonatal jaundice among caregivers in a tertiary health facility in Ghana. PLoS One 2021; 16:e0251846. [PMID: 34086736 PMCID: PMC8177863 DOI: 10.1371/journal.pone.0251846] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 05/04/2021] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Neonatal jaundice is a major reason babies are frequently re-admitted after hospital discharge following delivery. One means of improving neonatal care and reducing potential mortality associated with neonatal jaundice in resource-limited settings is to create awareness among caregivers. Caregivers who tend to have higher knowledge and awareness, also have positive attitudes, and are not guided by outmoded socio-cultural beliefs and practices are more likely to seek early care and treatment for neonatal jaundice. OBJECTIVE This study investigated caregivers' knowledge, attitude and practices regarding neonatal jaundice in a tertiary health facility in the Volta region of Ghana. METHODS This was a descriptive cross-sectional study that employed a quantitative approach for data collection. A total of 202 caregivers from the Ho Teaching Hospital in the Volta region of Ghana were sampled using a systematic random sampling strategy where quantitative data was collected using a questionnaire and analyzed with STATA version 14.0. Ordered logistic regression was used to determine the factors that were associated with caregivers' knowledge regarding neonatal jaundice and attitude after controlling for relevant covariates. RESULTS Less than half of the caregivers demonstrated good knowledge (45.5%) and attitude (47.5%) but 58.9% had good practices regarding neonatal jaundice. Caregivers who had prior awareness and education on neonatal jaundice were three times more likely to have good knowledge about jaundice than those without previous education [AOR = 3.02, (95%CI: 1.59-5.74), p = 0.001]. A caregiver employed in the public sector was two times more likely to have a good attitude about jaundice than those employed in the private sector [AOR = 2.08, (95%CI: 1.03-4.21), p = 0.042]. CONCLUSION Less than two thirds of the caregivers demonstrated good practice with limited knowledge and poor attitude. Efforts to promote well informed and improved caregivers' attitude will advance positive maternal health-seeking behavior and reduce disabilities and death through early detection and intervention of infants with neonatal jaundice. Public awareness and education about neonatal jaundice especially among caregivers in the private sector should also be intensified.
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Affiliation(s)
- Solomon Mohammed Salia
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
- * E-mail:
| | - Agani Afaya
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
- College of Nursing, Yonsei University, Seoul, South Korea
| | | | - Martin Amogre Ayanore
- Department of Health Policy Planning and Management, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Emmanuel Salia
- Central Laboratory, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Doreen Dzidzor Kporvi
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Peter Adatara
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Vida Nyagre Yakong
- Department of Midwifery, School of Nursing and Midwifery, University for Development Studies, Tamale, Ghana
| | | | - Shine Seyram Quarshie
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Eric Kwame Dey
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Dominic Amoah Akolga
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Robert Kaba Alhassan
- Centre for Health Policy and Implementation Research, Institute of Health Research, University of Health and Allied Sciences, Ho, Ghana
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22
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Tello-Torres C, Hernández-Vásquez A, Dongo KF, Vargas-Fernández R, Bendezu-Quispe G. Prevalence and Determinants of Adequate Compliance with Antenatal Care in Peru. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRÍCIA 2021; 43:442-451. [PMID: 34318469 PMCID: PMC10411206 DOI: 10.1055/s-0041-1732463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 05/27/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To determine the adequacy of compliance with antenatal care (ANC) by pregnant women in Peru and to identify the associated factors. METHODS An analytical cross-sectional study of data from the 2019 Peruvian Demographic and Family Health Survey (Encuesta Demográfica y de Salud Familiar, ENDES, in Spanish) was conducted. The dependent variable was adequate compliance with ANC (provided by skilled health care professionals; first ANC visit during the first trimester of pregnancy; six or more ANC visits during pregnancy; ANC visits with appropriate content) by women aged 15 to 49 years in their last delivery within the five years prior to the survey. Crude and adjusted prevalence ratios and their 95% confidence intervals were calculated using a log-binomial regression model. RESULTS A total of 18,386 women were analyzed, 35.0% of whom adequately complied with ANC. The lowest proportion of compliance was found with the content of ANC (42.6%). Sociodemographic factors and those related to pregnancy, such as being in the age groups of 20 to 34 years and 35 to 49 years, having secondary or higher education, belonging to a wealth quintile of the population other than the poorest, being from the Amazon region, not being of native ethnicity, having a second or third pregnancy, and having a desired pregnancy, increased the probability of presenting adequate compliance with ANC. CONCLUSION Only 3 out of 10 women in Peru showed adequate compliance with ANC. Compliance with the content of ANC must be improved, and strategies must be developed to increase the proportion of adequate compliance with ANC.
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Affiliation(s)
| | - Akram Hernández-Vásquez
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
| | - Karla F. Dongo
- Facultad de Medicina Humana, Universidad Científica del Sur, Lima, Peru
| | | | - Guido Bendezu-Quispe
- Universidad Privada Norbert Wiener, Centro de Investigación Epidemiológica en Salud Global, Lima, Peru
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